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What Are the Best Contact Lenses for Dry Eye?

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Daily life can come with some challenges after you’ve been diagnosed for dry eye disease at an eye exam, not the least of which is comfort. Another factor that many don’t think about is choice of eyewear. 

Glasses might be your preference, but depending on your choice of dry eye therapy (if you’re opting for it)—your suitability for them might change. Furthermore, your suitability for some contact lens lines might change as well. But the good news is, select contact lenses might actually help you with your dry eye rather than worsening it.

What is Dry Eye Disease?

Dry eye syndrome can come in several varieties, each with their own causes, levels of severity, and symptoms that depend on the patient.

Dry Eye & Your Cornea

Your cornea is the transparent surface of your eye that directs light into your retina, the light-capturing tissue at the back of your eyeball. This is the surface that most contact lenses sit on. If this part of your eye doesn’t get the moisture it needs, dry eye symptoms can get worse. It needs oxygenation to keep it healthy, and hydration to keep its shape.

Your Tear Film

Normally your tear film—a compound layer of mucous, water, and oil in balanced quantities—oxygenates and hydrates, while the oil layer keeps tears from evaporating too quickly.

But in patients with dry eye, there’s a problem with the supply or quality of one or more parts of the tear film. These issues lead to symptoms like redness or irritation, interfering with normal contact lens wear.

There are two main types of dry eye that patients tend towards.

Evaporative Dry Eyes

Evaporative dry eye means your tear film evaporates too quickly. Oftentimes there’s a blockage in the oil glands, impacting the oil layer. Dull pain and red appearance are common symptoms of evaporative dry eyes. If you have evaporative dry eye, you might benefit from many kinds of contact lenses and frequent or extended wear.

Aqueous Tear-Deficient Dry Eyes

In some cases of dry eye, there just isn’t enough water-content in your tears. Aqueous tear-deficient dry eye often traces to problems with your lacrimal glands, where your tears originate, meaning you don’t produce enough tears. 

Dry eye of this type may be caused by: 

However, for many patients, dry eye does not have an underlying cause or condition. Instead, it can simply be a result of getting older, your lifestyle/work habits, your environment, or a combination of factors.

piles of dried up contact lenses on grey

What Makes Contact Lenses Good for Dry Eye?

Not all contact lenses are created equal. When we fit and prescribe contact lenses for people with dry eyes, we focus on several different factors that can preserve moisture, so that they can provide some of the relief you need.

With the wrong choice of contact lenses, you can actually worsen your dry eye symptoms, as about 50% of contact wearers complain about that very thing.

Silicone Material

As of 2015, half of all contact lenses were made of Silicone Hydrogel, after being brought into the contact lens market in 1999. Their success owes to the kind of comfort they can provide, with minimization of redness, dryness, swelling of the cornea, and corneal infections.

Proper Fit

As you might be able to guess, buying contact lenses from a trusted optometrist is a lot better than buying them online—partly because it’s unlikely you’ll get a seller who follows safe eye care practices, including professional fittings. 

Your eyes can change over time, so outdated contact lens dimensions from your older prescriptions might not offer the same fit. That’s why your optometrist will always conduct a contact lens exam with a careful fitting. If a lack of moisture has impacted the shape of your cornea in severe cases, fitting becomes even more crucial. 

Water Content

Most soft contact lenses are made of around 50% water content, which keeps them flexible and in shape. If you’ve ever thrown away a pair of soft contacts, you might have noticed how they shrivel up at room temperature and humidity.

Some contact lenses contain different materials to help with the issues of water content. High water content tends to dry the contact lens, and by extension your cornea. But different materials can change the evaporation rates affecting your cornea’s moisture levels. In particular, Silicone Hydrogel holds less water, which helps dry eye patients.

Oxygen Permeability

If you’ve been having trouble with dry eye due to the material of your contact lenses, choosing lenses based on their oxygen permeability could be the factor irritating your eyes. Hydrogen Silicone soft lenses have a relatively high oxygen permeability rating, so they can trap moisture and let oxygen from outside the sealed lens in.

Types of Contact Lenses

Daily contact lenses, or specialty contact lenses with extended wear options can grant a lot of freedom—if they come in the right material, like Hydrogen Silicone. Dailies made from these materials grant lower evaporation rates and good comfort.

For those who have extreme cases of dry eye, scleral lenses may be an option. These large lenses go over the whites of the eyes (sclera) and vault over the cornea, creating a fluid reservoir, covering the cornea and surrounding surfaces. 

Immobilized tears can hydrate and relieve dry eyes with corneal irritation. As the lenses and the fitting costs tend to be much higher with Scleral Contact lenses these are generally reserved for more severe cases.

Maintenance and Replacement

If you have dry eye, contact lens maintenance and replacement becomes that much more critical. Each contact lens product line can be a little different so follow the instructions your optometrist gives. Replacing according to the package should guarantee that your contact lenses will act as your optometrist intends. If you don’t replace them in time, it could impact your dry eye symptoms negatively.

Proper Care & Cleaning

Depending on whether you’ve opted for rigid or soft lenses, there can be small differences in how to maintain lenses that help with your dry eyes. 

If you have dry eye, your optometrist will likely recommend daily contacts, eliminating the risk of build-up and other issues that can make dry eyes worse. Further, solutions are designed with chemicals to clean and disinfect, and it is these very products that contribute to dry eye problems.

Even when using daily contacts, you should always care for and handle your contacts properly:

  • Wash and rinse your hands before handling your contact lenses.
  • Only use approved cleaning solutions, never water
  • Don’t use expired contacts or cleaning solutions.
  • Store the contact lenses and seal them with your container’s caps.
  • Dispose of contact lenses after the recommended use period, never longer.

What Products & Brands Should I Buy?

For most patients, daily or 1-day contact lenses are the best option for those with dry eye. Not only are they more convenient, but they eliminate the risk of build-up on the contact lenses, a major contributor to dry eye. 

Acuvue Oasys 1-Day

Oasys lenses are well-suited to dry eye in their own right, but getting dailies ensures the lens is in top condition and combats relative dryness, every day. The 1-Day line combines this key feature with disposability. If you’re looking for day-by-day contact lenses use and relief only rarely, while looking to avoid discomfort, these might be a good fit for you.

Acuvue’s HydraLuxe has tear-like properties leaving you comfortable all day. Dry eye can be triggered by an overly dry or windy climate or interior, so you may want these lenses if you’re exposed.

Acuvue Moist Multifocal 1-Day

The Acuvue Moist Multifocal 1-Day contact lenses are another great option, especially for those with presbyopia and dry eye.

The lens contains multiple prescriptions to help you see objects close up and far away. As a daily contact lens, you also avoid issues with build-up that can exacerbate dry eye symptoms. 

Ask Your Optometrist at Your Fitting

The great part about getting an eye exam from us is in getting a list of contact brands that suit your unique case of dry eye, with competent fitting, and a one-stop shop that you can make use of online or in-person. Please don’t hesitate to reach out for a careful lens fitting. With the best set of contacts, dry eye relief can work harmoniously with your other eye care needs.

Written by Dr. Robert MacAlpine

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